Subdural hematoma natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: , Fahimeh Shojaei, M.D.

Overview

If left untreated, 14% of patients with subdural hematoma may progress to serious complications including death. Common complications of subdural hematoma include memory loss, dizziness, headache, anxiety, difficulty concentrating, seizures, temporary or permanent weakness, numbness, difficulty speaking, brain herniation, coma, death. Depending on the extent, type, and locationat of hematoma at the time of diagnosis, the prognosis may vary.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of chronic subdural hematoma usually develop in the sixth and seventh decade of life.[1][2]
  • In acute subdural hematoma, the symptoms of SDH typically develop 24 hours after head injury.
  • In subacute subdural hematoma, the symptoms os SDH typically develop between 1 to 10 days after head trauma.
  • In chronic subdural hematoma, the symptoms of SDH typically develop weeks or months after head trauma
  • If left untreated, 14% of patients with subdural hematoma may progress to serious complications including death.

Complications

Common complications of subdural hematoma include:

  • Memory loss
  • Dizziness
  • Headache
  • Anxiety
  • Difficulty concentrating
  • Seizures
  • Temporary or permanent weakness
  • Numbness
  • Difficulty speaking
  • Brain herniation
  • Coma
  • Death

Prognosis

  • Acute subdural hematoma prognosis is generally poor, and the case mortality rate of traumatic subdural hematoma is approximately 14%.
  • Acute subdural hematomas has high rates of death and injury.
  • Depending on the extent, type, and locationat of hematoma at the time of diagnosis, the prognosis may vary.
  • However, the prognosis is generally regarded as poor in acute subdural hematoma and good in chronic subdural hematoma.
  • Subacute and chronic subdural hematomas have better outcomes in most cases, with symptoms often going away after the blood collection is drained.
  • There is a high frequency of seizures following a subdural hematoma, even after drainage.
  • These seizures are usually well controlled with medication.
  • Seizures may occur at the time the hematoma forms, or up to months or years afterward.
  • A period of rehabilitation is sometimes needed to assist the person back to his or her usual level of functioning.

References

  1. Kalanithi P, Schubert RD, Lad SP, Harris OA, Boakye M (November 2011). "Hospital costs, incidence, and inhospital mortality rates of traumatic subdural hematoma in the United States". J. Neurosurg. 115 (5): 1013–8. doi:10.3171/2011.6.JNS101989. PMID 21819196.
  2. Kanat A, Kayaci S, Yazar U, Kazdal H, Terzi Y (September 2010). "Chronic subdural hematoma in adults: why does it occur more often in males than females? Influence of patient's sexual gender on occurrence". J Neurosurg Sci. 54 (3): 99–103. PMID 21423076.

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